Lawmakers question lack of interoperability on the Hill — DeSalvo’s got a lot on her plate, ONC responds to critics

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07/18/2014 10:04 AM EDT

Presented by Better Medicare Alliance

With help from Arthur Allen (@ArthurAllen202) and David Pittman (@David_Pittman)

INTEROPERABLITY TURNS INTO FIGHTING WORD ON THE HILL, LAWMAKER BLASTS EPIC EHR SYSTEM: Interoperability is a mouthful, but it became a fighting word on the Hill on Thursday as members of the House Energy and Commerce Committee attacked the meaningful use program for failing to enable the free flow of health information among patients, providers and researchers. Republicans, encouraged by witnesses at a joint hearing of the subcommittees on communications and health, also spoke of the need to put legislative borders around federal regulation of health IT. The harshest language on meaningful use program came from Rep. Phil Gingrey (R-Ga.), who charged that Verona, Wis.-based Epic Systems, the leading EHR company, was operating “closed platforms” that did not allow information to easily flow into and out of its electronic health records systems. “We have responsibility for ONC and the HITECH act. We’ve spent tens of billions on non-interoperable products,” Gingrey said. “It may be time for us to look closer at the activities of vendors in the space, given the possibility that fraud is being perpetrated on the American people.” Epic has received billions in contracts from doctors and hospital systems subsidized to improve their electronic health records through the 2009 HITECH Act.

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Rep. Bill Cassidy (R-La.), also a doctor, said the federal government needed to figure out a way to discourage closed systems, so that “it doesn’t get stuck in amber that Epic gets market share without sharing.” Epic Systems President Carl Dvorak said Gingrey’s comments were false. The full story: http://politico.pro/1tbGZbb

Welcome to Friday morning eHealth. We’re betting that yesterday was one of the few times an EHR company had to defend itself to lawmakers on the Hill. Ping us with your feedback at agold@politico.com and connect with us on Twitter @POLITICOPro; @Morning_eHealth.

KAREN DESALVO HAS A LOT ON HER PLATE: And she keeps adding more, David Pittman reported Thursday. The national coordinator for health IT has made improving interoperability of electronic health records a priority. She’s trying to build a national health IT safety center and overseeing the rollout of the next phase of the massive federal incentive program for EHRs. In addition, she told reporters Thursday, federal health officials want to broaden efforts to integrate data not traditionally captured in a patient’s electronic health record. DeSalvo said the federal health IT strategic plan — which has focused on where people receive care — is being widened to extend health IT to where people live, learn, work and play. Moving beyond the health care system “opens us up for lots of conversations about big data and privacy and security and HIPAA,” she said during a wide-ranging, hour-long talk. “There’s an opportunity to be more inclusive in types of data.” DeSalvo mentioned data coming from public health and social service agencies, consumer-generated data and genomics. That information “needs a home,” she said, but policymakers must figure out standards on how it is exchanged, and who controls it. http://politico.pro/1tbHF0b

ONC RESPONDS TO HOUSE QUESTIONING OF ITS AUTHORITY: In a response to GOP leaders of the Energy and Commerce Committee, DeSalvo sought to correct perceptions that her agency intended to regulate health IT safety, and said ONC’s actions were covered under the laws that established it. In the June 3 letter to DeSalvo, Energy and Commerce chairman Fred Upton, vice chairman Marsha Blackburn, and subcommittee chairs Joseph Pitts and Greg Walden pointedly asked what authority ONC had to create a patient safety center “to regulate health IT,” and what grounds ONC had to levy a tax on health IT companies to pay for its operations. DeSalvo, in a July 8 response released by the committee to POLITICO today, noted that the safety center had never been proposed as a regulatory body but rather a gathering place “that includes broad representation from public and private stakeholders to establish a governance structure for the creation of a sustainable, integrated health IT learning system that avoids regulatory duplication.” As for the tax, ONC wanted user fees to pay for its certification work, but never got them, she said.

DOCS RANK FAVORITE EHRs: Epic remains the most highly used EHR among physicians polled by Medscape in its annual EHR survey, with Cerner coming in second. Epic topped the list the last two years. The VA’s EHR system was rated first overall by preference, though, and ranked highly on satisfaction, ease-of-use scores and usefulness as a clinical tool, as well. Docs rated Practice Fusion as having the best support. Sixty-three percent of docs said more than anything else an EHR does, it helps them improve documentation. Seventy percent said it decreases time spent talking to patients. See the whole survey: http://bit.ly/1tbQkQb

TELEHEALTH IS AS VITAL AS EMAIL, SAYS HEALTH IT DOC: Without updated federal laws and policies for telehealth, millions of people will go without lifesaving therapies, says the medical information chief of the VNA Health group. At a Hill briefing hosted by Disruptive Women in Healthcare Thursday, physician Wen Dombrowski compared telehealth to email. “If I took away your email, how would that affect your work? Your deadlines; your communication? It would cripple all of us,” said Dombrowski. “People think telehealth is science fiction, this far out thing.” Many health care organizations depend on charitable funds to pay for telehealth because the service is usually not eligible for Medicare reimbursement. Yet federal reimbursement for telehealth would save thousands in hospitalizations and nursing home stays, she said. “Who has time to go to the doctor’s office? Healthy people are too busy. Sick people have trouble getting out of the house. And poor people can’t get to the doctor’s office for a variety of reasons.” The federal government wants to better outcomes, better care and lower costs, but won’t pay for care at home. It’s “contradictory and disconnected,” she said.

CAMPAIGN PRO LUNCHEON BRIEFING: Join members of the Campaign Pro team for an interactive conversation about who is up, who is down, what to expect for the 2014 midterm elections and implications for 2016 on Monday. Find more information and RSVP: http://politi.co/Wi98ml.